For members enrolled in an IBC prescription drug program, prior authorization
requirements will be applied to certain drugs. The purpose of prior
authorization is to ensure that drugs are medically necessary and are being
used appropriately. The most recent updates are reflected below.
Drugs requiring prior authorization
The prior authorization requirement for the following non-formulary drugs was
effective at the time the drugs became available in the marketplace:
Brand drug
Generic drug
Drug category
Effective date
Edarbyclor
TM
Not available
Heart, Blood Pressure, & Cholesterol
February 13, 2012
Erivedge
TM
Not available
Cancer & Organ Transplant
February 13, 2012
Inlyta
®
Not available
Cancer & Organ Transplant
February 13, 2012
Jentadueto
TM
Not available
Diabetes, Thyroid, Steroids, & Other Misc Hormones
February 17, 2012
Kalydeco
TM
Not available
Diagnostic & Miscellaneous Agents
February 24, 2012
Picato
®
Not available
Skin Medication
March 9, 2012